Communication ETDs

Publication Date

Spring 5-4-2018


Pakistan is one of the three countries where polio remained endemic in 2017—the other two being Afghanistan and Nigeria. The highest number of polio cases, 15, was recorded in Pakistan in 2016. A majority of the polio cases emerged among the ethnically Pakhtun population living in Pakhtunkhwa, FATA (the Federally Administered Tribal Areas), and Karachi, a metropolitan city in the Sindh province where Pakhtun immigrants from Pakhtunkhwa and FATA work and live. The resistance to polio vaccination among Pakhtuns has been associated with several factors, including a lack of knowledge about polio and anti-polio vaccine, the ongoing “war on terror,” conspiracy theories surrounding the vaccination campaigns, the public’s lack of trust in the government, and poor health infrastructure in the Pakhtun-dominated areas. The government of Pakistan and UNICEF devised a strategy that stresses the importance of media in reaching the resistant communities. Journalists play an important role in the creation and dissemination of health information and, therefore, are important potential stakeholders in the polio eradication campaigns. However, past research did not examine the role of the local journalists in the local public health issues, especially the polio vaccination campaigns in Pakistan. Furthermore, past scholarship focused on journalists’ identity and their role in dissemination of health-related information in high-resources settings, predominantly in English speaking countries. The voices of local journalists who are also active members of their communities are missing from the dominant discourse on health issues in their communities and the media coverage of those issues in the subaltern context. It is therefore important to understand the perceptions of local journalists about health issues in their communities and their role in covering health issues in the subaltern contexts.

Using a constructivist grounded theory approach, this study seeks to understand: 1) the perceptions of local journalists about the media coverage of health issues; 2) what journalists say are the factors that influence their own coverage of health issues; 3) their perceptions of the reaction to polio vaccination among the Pakhtun communities; 4) their own perceptions of the importance of the vaccination; 5) their perceptions of the media coverage of polio vaccination; 6) the factors that influence their (own) coverage of polio vaccination.

The journalists recruited for this study included local journalists (n=26) covering health for Urdu language newspapers (n=9); journalists covering health for radio outlets (n=6); and journalists who covered different beats, including health, for several media outlets from districts or agencies (n=11). They ranged in age from 27 to 59 (M=36.01), and their experience as journalists ranged from five years to 23 years (M=7.51); most of them have covered health beats for more than two years (M=2.7). All of the journalists were married. All of them were male.

The overarching analytical category that emerged was a tension between western-like ideals of journalism and the political-economic reality of the local context. The journalists were performing several identities and the intersection of those identities created a tension that resulted in the poor coverage of health issues. The local health journalists had a journalistic identity that was influenced by western ideology of journalism, but they tried to adjust the western journalistic ideology to the local realities. The journalists walked a thin line between maintaining their professionalism and surviving in the job market. The tension between professionalism and survival forced the journalists to perform what I theorize as hybrid professional identities. The participants noted that the media organizations based in the major cities downplayed or ignored the health issues in Pakhtunkhwa and FATA— the two areas in the peripheries of Pakistan. The participants regarded lack of personal/professional capacity of journalist to cover health issues and lack of professionalism in the field of journalism as the two main factors that influenced their own coverage of health issues. A majority of the participants associated resistance to polio vaccination in the Pakhtun communities to the lack of basic health facilities in the Pakhtun in the communities, the inability of the government and its international partners to frame polio as a local public health issue, and religious beliefs that resulted in rumors about polio vaccination. The local journalists also believed that they were not equipped to cover polio vaccination related issues properly that at times result in the inclusion of rumor-based information in their news stories.

Based on the findings of my study, I propose a model of influencers on the local health journalists’ coverage of health issues in the low resources subaltern context. I also add to the literature on agenda-building theory by problematizing the relationship between journalists and public relations officers in a subaltern context.

In order to create awareness about health issues UNICEF, WHO, and health communication and public health scholars need to tailor their communication strategy to eradicate polio vaccination according to the needs of the local communities.




Journalism, polio vaccination, health reporting, health communication, journalistic identities, health campaigns

Document Type


Degree Name


Level of Degree


Department Name

Department of Communication and Journalism

First Committee Member (Chair)

Dr. Tamar Ginossar

Second Committee Member

Dr. Judith White

Third Committee Member

Dr. Ilia Rodriguez

Fourth Committee Member

Dr. David Weiss

Fifth Committee Member

Dr. Julia Meredith Hess

Available for download on Thursday, July 28, 2022